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BACKGROUND: Across the care economy there are major shortages in the health and care workforce, as well as high rates of attrition and ill-defined career pathways. The aim of this study was to evaluate current evidence regarding methods to improve care worker recruitment, retention, safety, and education, for the professional care workforce. METHODS: A rapid review of comparative interventions designed to recruit, retain, educate and care for the professional workforce in the following sectors: disability, aged care, health, mental health, family and youth services, and early childhood education and care was conducted. Embase and MEDLINE databases were searched, and studies published between January 2015 and November 2022 were included. We used the Quality Assessment tool for Quantitative Studies and the PEDro tools to evaluate study quality. RESULTS: 5594 articles were initially screened and after applying the inclusion and exclusion criteria, 30 studies were included in the rapid review. Studies most frequently reported on the professional nursing, medical and allied health workforces. Some studies focused on the single domain of care worker education (n = 11) while most focused on multiple domains that combined education with recruitment strategies, retention strategies or a focus on worker safety. Study quality was comparatively low with a median PEDro score of 5/10, and 77% received a weak rating on the Quality Assessment tool for Quantitative Studies. Four new workforce strategies emerged; early career rural recruitment supports rural retention; workload management is essential for workforce well-being; learning must be contextually relevant; and there is a need to differentiate recruitment, retention, and education strategies for different professional health and care workforce categories as needs vary. CONCLUSIONS: Given the critical importance of recruiting and retaining a strong health and care workforce, there is an immediate need to develop a cohesive strategy to address workforce shortfalls. This paper presents initial evidence on different interventions to address this need, and to inform care workforce recruitment and retention. Rapid Review registration PROSPERO 2022 CRD42022371721 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022371721.
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Aprendizagem , Serviços de Saúde Rural , Humanos , Pré-Escolar , Adolescente , Idoso , Recursos Humanos , Pessoal Técnico de Saúde , Carga de Trabalho , Saúde MentalRESUMO
BACKGROUND: The adoption of research evidence to improve client outcomes may be enhanced using the principles of implementation science. This systematic review aimed to understand the effect of involving consumers to change health professional behaviours and practices. The barriers and enablers to consumer engagement will also be examined. METHODS: We searched Medline, CINAHL, Embase, the Cochrane Central Register of Controlled Trials and PDQ-Evidence from 2004 to February 2019. Implementation studies involving consumers in at least one phase (development, intervention or facilitation) of an intervention that aimed to change health professional behaviour to align with evidence-based practice were included. Studies in the areas of paediatrics and primary care were excluded. Two review authors independently screened studies for inclusion, and one author extracted data and conducted quality assessments with review of a second author. Knowledge translation interventions were categorized using the Effective Practice and Organisation of Care taxonomy. The primary outcome was measures of change in health professional behaviour. RESULTS: Sixteen articles met the inclusion criteria. Meta-analysis of three studies found support for consumer involvement in changing healthcare professionals' behaviour (Hedges' g = 0.41, 95% CI [0.27, 0.57], P < 0.001). Most knowledge translation studies involved consumers during the development phase only (n = 12). Most studies (n = 9) included one type of knowledge translation intervention. Professional interventions (including education of health professionals, educational outreach, and audit and feedback) were described in 13 studies. CONCLUSIONS: Consumer involvement rarely moves beyond the design phase of knowledge translation research in healthcare settings. Further research of the barriers to and effect of increased consumer engagement across all stages of knowledge translation interventions is needed. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019119179.
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Comportamentos Relacionados com a Saúde , Pessoal de Saúde , Criança , Participação da Comunidade , HumanosRESUMO
INTRODUCTION: In most sub-Saharan African countries, studies on the impact of out-of-home care experience on the transition of young adults leaving care are limited to those leaving institutional or foster care with no empirical evidence on the experiences of those moving out of kinship care. This study reports findings from interviews with young adults with experience of kinship care in Ghana, about what lessons their kinship care experiences provided in their transition to adulthood. METHOD: Twenty-five young adults aged 21-25 years (17 males, 8 females) with kinship care experience from rural communities in Ghana were purposively selected. Using a semi-structured interview guide, a qualitative short narrative approach was employed. Consistent patterns from the short narratives were analysed using the qualitative thematic approach. RESULTS: Key themes identified from the participants' narratives were a) learning from life experiences b) better decision making and c) development of resilient strategies. Young adults reported that they shaped their lives with lessons from negative experiences, advice received from caregivers and management skills obtained from the unskilled income generating activities they undertook whilst in kinship care. CONCLUSION: The study provides evidence for policymakers to consider kinship care as an effective, suitable and cost-effective alternative care arrangement for children in need of adequate parental care in Ghana. When assessing kin's suitability to provide care, some emphasis should be on caregivers' needs and assessment of activities engaged in by children living in kinship care. Social workers should provide counselling and education support to children moving out of kinship care.
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Cuidados no Lar de Adoção/psicologia , Vida Independente/psicologia , Adaptação Psicológica , Adulto , Cuidadores/organização & administração , Feminino , Gana , Humanos , Masculino , Pesquisa Qualitativa , População Rural , Adulto JovemRESUMO
BACKGROUND: Cultural connection for Aboriginal young people promotes wellbeing, resilience and healing. There is little research on the social and emotional wellbeing (SEWB) impacts of cultural strengthening programs for Aboriginal young people, especially research that includes the perspectives of young people. There is even less research that includes the experiences of Aboriginal young people who have been in out-of-home care. OBJECTIVE: The current study sought to address these research gaps by exploring the SEWB impacts of cultural strengthening programs by amplifying the voice of Aboriginal young people, including those who have been in out-of-home care. PARTICIPANTS AND SETTING: Aboriginal young people involved in an innovative cultural strengthening program, the Narrun Yana art collective, established by the Victorian Aboriginal Child Care Agency (VACCA). Also participating was VACCA's Team Leader of Children and Youth Programs, thus providing both experiences of participating in and of organising cultural programs. METHOD: A qualitative phenomenological approach was taken. Data consisted of semi-structured interviews with the team leader and two young people and written responses to the interview questions from one young person. RESULTS: Lived experience provided evidence that cultural strengthening programs; help strengthen SEWB, including connection to self, relationships, community and culture; contribute to building resilience in the context of intergenerational trauma, cultural loss and racism; and encourage help-seeking, both informal support and accessing mental health services. Young people also viewed participating in the research as worthwhile. CONCLUSIONS: Findings highlighted the importance of Aboriginal young people having opportunities to; connect to culture through participation in cultural strengthening programs, and engage in the design of these programs.
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Povos Aborígenes Australianos e Ilhéus do Estreito de Torres , Assistência à Saúde Culturalmente Competente , Serviços de Assistência Domiciliar , Adolescente , Humanos , Emoções , Povos Indígenas , Austrália , CulturaRESUMO
Introduction: Consistent with international promulgation on the criminalization of filicide, Ghana's Children's Act 1998 (560) and the Criminal Justice Act criminalizes any form of torture against children. Yet, perpetrators of filicide in Ghana may go unpunished due to the beliefs in cultural norms that justify filicide acts. The cultural narratives of filicide can impede on the application and effectiveness of the laws of filicide. Method: The study employed a vignette approach to explore the views of 19 adults, who were parents between 69 years of age and 30 years of age, in rural and urban Ghana on the laws of filicide in Ghana and filicide intervention measures. The interviewees were provided with narratives on two different vignettes (developed based on real life cases), followed by semi-structured questions to probe the narratives. The interviews were analyzed following Fraser's narrative thematic analysis procedure. Results: The study identifies the association between cultural beliefs and the communities' understanding of the concept of filicide. Though community members are aware of the criminalization of filicide acts, the majority of them were not informed about the laws against filicide in Ghana. Addressing filicide cases within the community was the most preferred option for the participants, as they believe that some children, termed "spirit children" (SC), deserve to be killed. Resorting to spiritual intervention from concoction men emerged as the normative pathway to obtain community approval for filicide. Police interventions were considered necessary in non-spiritual related filicides. Community members were only prepared to cooperate with the law in filicide cases if the filicide act has no connection with spirituality. Conclusion: The study adds to understanding of the concept of filicide outside western societies. The importance of intensive community campaigns against filicide acts, and norms that support filicide acts, has relevance for all counties.
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Objectives: The purpose of this paper is to highlight the impact of a pandemic on the lives of vulnerable members of the community who have experienced or are 'at risk' of experiencing intimate family violence and child abuse in Saudi Arabia. By reviewing the experience in Saudi Arabia in the context of the international literature, the study explores similarities and differences in the impact of the pandemic on family violence. Methods: The study investigated the impact of the COVID-19 pandemic on family violence and child abuse in Saudi Arabia by conducting a comparative analysis of the prevalence of cases, types of abuse, and geographical location of those experiencing violence between the years 2019 and 2020. Data were obtained from the Family Violence Reporting Center 1919 in Saudi Arabia. Results: The study found that the risk of family violence and child abuse increased during the COVID-19 pandemic in Saudi Arabia, similar to findings in other countries. Conversely, there was a decrease in the number of reports due to factors associated with COVID-19. Conclusions: The study highlighted the importance of ensuring that existing policies and services are sufficient to ensure the risks arising from the impact of COVID-19 responses and minimize the negative consequences.
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BACKGROUND: Contrary to evidence from the Western literature, cases of filicide in Ghana are mostly unreported because they are rooted in cultural practices and hidden from the general public. OBJECTIVE: The purpose of this study was to explore the cultural context of filicide in a rural community. Particularly, to provide an understanding of the spirit child (SC) phenomenon, how the killing of a SC is performed and to provide a general understanding of filicide within a particular context. PARTICIPANTS AND SETTING: Four relatives of a family that engaged in a filicide incident took part in the study. The interviews were conducted in a rural community in Ghana where the incident occurred. METHODS: Short written narratives were used to explore the experiences and perceptions of relatives whose family engaged in filicide. RESULTS: Children with severe deformities are likely to be associated with matters of divinity which gives way for the conceptualization of the SC and its attendant filicide. The findings highlight the critical role of traditional healers in rural communities and the consequences of strong community beliefs and expectations that influence parents to commit filicide. CONCLUSION: The study provides directions for child protection workers to address the stigma parents face for having children with severe deformities and to provide education on child welfare legislation.
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Família , Pais , Criança , Proteção da Criança , Gana , Humanos , População RuralRESUMO
Almost nothing is known about how the infant may experience being in a women's Refuge (Shelter) setting with their mother after fleeing family violence, despite the high numbers of infants and young children in Refuges or Shelters. This research was concerned with exploring how the infant experienced refuge within a Refuge setting post family violence. Using a non-intrusive, ethically informed, 'infant led' approach, this research involved ten infants (aged 3 weeks to 16 months), ten mothers, and 13 staff in eight Refuges from three countries: Australia, Scotland and England. Data was collected through infant observation, interviews with mothers and then staff. Presented is a synthesis of a research methodology which was led by the infant, drew on concepts of 'inter-subjectivity' and used a constructivist grounded theory method. Infants were often lost from view within the Refuge setting. The mother, herself traumatised, was expected to be the refuge for her infant. Only the obviously distressed infant was assisted, and where available, from outside specialist workers. It was often too painful for the adults, both mothers and staff, to see or reflect on the infant's possible trauma. Significantly, in all cases the motivation for each mother to enter Refuge was ensuring their infant's safety. Concern for their infant or young child can be a powerful catalyst for women leaving a violent relationship. Refuges (Shelters) are in a unique position to respond to the infant in their own right whilst helping to heal and grow the infant/mother relationship.
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Background: Childhood maltreatment such as abuse, neglect and family violence has a profound impact on children's psychological and relational functioning and their lifelong trajectory, with associated adverse physical and mental health outcomes, higher mortality rates and reduced socioeconomic opportunities. The aim of the study was to explore the impact of neurodevelopmentally- and trauma-informed interventions on the relational health of children who have experienced maltreatment. Context: The study was conducted at Berry Street Take Two, an Australian therapeutic service. Take Two provides services to Victorian children aged 0-18 years, to address the impact of the trauma they have experienced from maltreatment. Take Two clinicians use relational and ecological frameworks, neurodevelopmental research and evidence-informed approaches to repair family relationships and develop networks of caring adults that focus on meeting the child's needs. Take Two uses the NMT approach as a framework for clinical intervention-planning and is site-certified in the use of the NMT Clinical Practice tools. Method: The mixed methods study had two components. A cross sectional study of baseline and repeat clinical measure data (HoNOSCA and SDQ) with a cohort of children aged 2-11 years (n = 91), who were clients of Berry Street Take Two between 2014 and 2019, was conducted utilizing SPSS. The quantitative data analysis was supplemented by three case studies of Berry Street Take Two clients, which explored the process of intervention, including intervention type, timing and dosage. The case studies drew on the full case record for each child to illustrate the impact of NMT-informed interventions on the relational health, psychological and behavioral functioning of children. Results: The study found that Take Two intervention was associated with improved relational health, measured by the NMT metric and supported by significant positive changes on the SDQ and HoNOSCA with medium effect sizes (cohen's d). The case study analysis highlighted the importance of intervention addressing individual, family and systems elements to bring about positive change. Conclusions: This study illustrates the value of neurodevelopmental trauma-informed interventions in positively impacting on the relational health and current functioning of maltreated children and the potential to reduce the lifelong impact of maltreatment.